Tuesday, June 12, 2012

Cause of Death: Norwegian swimmer Dale Oen died of heart disease

There were some that suggested Epogen the day after he died. Shame on you.
From Fox News: 
"Based on the autopsy findings and the investigative history that is available to me, it is my opinion that Alexander Dale-Oen died of atherosclerotic coronary artery disease," Coconino County medical examiner Lawrence Czarnecki wrote in a report. 
The second tests revealed "severe atherosclerotic disease of the coronary arteries" supplying blood to the heart, and found that the left descending artery was "occluded" by "atherosclerotic plaque." "The decedent's only known risk factor for heart disease was familial," Czarnecki found, noting that one of Dale Oen's grandfathers died suddenly of heart disease at age 42. 
"Given the decedent's young age and significant atherosclerotic disease, a follow-up and evaluation of family members is recommended," he added...." 


Anonymous said...

Shame on you? Epogen (recombinant erythropoieten) can still have been the cause. This autopsy finding does not rule it out. It is extremely rare for an elite athlete do die so young of coronary artery disease. It is possible that something expedited the process.

Tony Austin said...

Epogen does not harden your arteries nor does it cause a family history of the disease.

Atherosclerosis when fat and cholesterol cholesterol enter the bloodstream, collects along the walls of arteries and hardens into plaque. Therefore the evidence regarding what caused his death could be seen and even touched.

You liver manufacturers cholesterol and if you have a genetic predisposition for it to overproduce cholesterol as did both Dale Oen and a direct family member, no amount of exercise or diet can compensate.

Only within the last 3-years or so have kids as young as 9-years-old have been recommended to get regular Cholesterol checks.

In hindsight Mr. Oen should have been given regular cholesterol checks and been given Statin drugs.

Instead of rushing to Epogen as the cause I suspect that it's far more reasonable to believe that at his age and his observable health and Olympic status that it was overlooked.

Anonymous said...

Tony, i am not accusing him of epogen. I work in cardiac rehabilitation and deal with heart disease daily. Young kids getting statin drugs are either a)born with familial dyslipidemia, or b) have high lipid values because they are overweight. Dale definitely was not the latter. Maybe the former but neither you nor I know that. According to reports on SwimmingWorld and SwimNews his cholesterol was only 'slightly elevated'. This likely means his cholesterol was in the 200 to 250 range (normal below 200). No one would put a 26 year old on statins for that. Familial dyslipidemia has these values in the 500+ range and also out of control LDL cholesterol, low HDL and extremely high (in the 1000's) triglycerides. Having a grandfather die at 42 is a risk....but typically in those types of situations when it is hereditary there are far more in the family affected.

You are only partially correct about how atherosclerosis results in a myocardial infarction. Once the plaque occurs the typically result to cause a thrombus (clot) is a rupture of the plaque and a sudden clotting response of the body in the area in an attempt to heal the rupture. If the lumen of the artery is narrowed and this occurs the blood flow can be stopped resulting in heart damaage and if it is large enough...death.

This is HIGHLY irregular in elite athletes. I am just saying that epo could be a factor. If taken in high enough doses (i.e., dosing yourself and not knowing what you are doing) if can raise the hematocrit (# of red blood cells) so high that it can clot in small arteries like those of the heart. In combination with altitude where everyone dehydrates could be a lethal outcome because that would add to the thickening of the blood. Additionally, the toxicology was negative. But these only test for illicit drugs and not epo. Epo is not routinely tested in a normal autopsy. They are special tests (http://www.haematologica.org/content/88/3/333.abstract). Not sure if it can be tested in someone who is deceased. But it should be a concern. Have they interviewed the athletes staying with him about it? Not that i have read. this should be done.

Finally, the fact that it took a second autopsy assessment to find something as simple as a heart attack makes me suspicious. This is very easy to detect and would have been easily evident on the initial autopsy. You can't say they didn't look for it because of his age and elite athlete status. They always look over the heart when it is suspected to be the cause of death. While I don't know if anything else caused it I sure thing we need more answers.

Canuckswimmer said...

Well said Anonymous. I'm both impressed by your apparent expert knowledge of the subject, and distressed (but not too surprised) that indeed Epo could be a factor in his untimely death.
Tony - you've been 'burned'.

Tony Austin said...

Wow, Lazarus come back from the dead. Good to hear from you again. Hope you are swimming

Look, I am not qualified to debate a doctor who spent a least a decade or more learning this stuff so I simply published his articulate rebuttal.

I just think that suggesting Epogen may have been a factor when there is a grieving family and a autopsy report by a competent doctor stating otherwise was premature and impolite.

With this published rebuttal, I sincerely hope that the Ninjas at WADA are taking this just as seriously as the Anon-Doctor and retesting his samples.

Anonymous said...

there is a lot that testing or autopsies don't pick up.. (remember how marion jones never failed a drug test.. more recently, lance armstrong is in trouble again and he's passed over 500 tests, as he said).